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Vilnius University Hospital Santariškių Klinikos

CARRE project
CARRE project
CARRE projectCARRE project

R. Kizlaitis, Vilnius University Hospital Santariškių Klinikos – International eHealth projects, Presentation at The Royal Hospital, Oman, Muscat 30 January 2015

Vilnius University Hospital Santariškių Klinikos

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Vilnius University Hospital
Santariškių Klinikos
SANTARA valley – integrated center of
science, studies, clinical practice and
business
LMB
IMC
VUH SK
VU OI
RTILUL
VU MF
VU MF
SPC
VUCH
Lab
VUH ŽK
VUCH
BIOTECH
Structure of the Hospital
PI Vilnius University
Hospital Santariškių
Klinikos
Children‘s
Hospital,
Affiliate of
Vilnius
University
Hospital
Santariškių
Klinikos
Infectious
Disease and
Tuberculosis
Hospital,
Affiliate of
Vilnius
University
Hospital
Santariškių
Klinikos
National
Centre of
Pathology,
Affiliate of
Vilnius
University
Hospital
Santariškių
Klinikos
Activity in the Year 2013:
• 2 102 beds;
• 83 532 in-patients;
• 780 494 out-patient consultations;
• 37 472 operations.
Hospital Employees in 2013:
• Total: 5078 staff members;
• (302 – PhD doctors)
Vilnius University Hospital Santariškių
Klinikos
University Hospital – the Basis of Studies and
Research
• University-based studies and
scientific research;
• 500 students, 260 residents, 300
doctors in refresher courses daily;
• 94 new PhD within 2002-2014.
• Tertiary level specialized medical
services;
• Science-based medicine.
Multi-profile Adult Hospital: 28 medical
centres
• All therapeutic specialties, including Oncology and
Neurosurgery
10 surgical centres:
• Centre of Abdominal Surgery
• Centre of Cardiac surgery
• Centre of Ear, Nose and Throat Diseases
• Centre of Eye Diseases
• Centre of Urology
• Centre of Thoracic Surgery
• Centre of Plastic and Reconstructive Surgery
• Centre of Obstetrics and Gynaecology
• Centre of Anestesiology, Intensive Care and Pain
Management
• Centre of Neurosurgery

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Vilnius University Hospital Santariškių Klinikos

  • 2. SANTARA valley – integrated center of science, studies, clinical practice and business LMB IMC VUH SK VU OI RTILUL VU MF VU MF SPC VUCH Lab VUH ŽK VUCH BIOTECH
  • 3. Structure of the Hospital PI Vilnius University Hospital Santariškių Klinikos Children‘s Hospital, Affiliate of Vilnius University Hospital Santariškių Klinikos Infectious Disease and Tuberculosis Hospital, Affiliate of Vilnius University Hospital Santariškių Klinikos National Centre of Pathology, Affiliate of Vilnius University Hospital Santariškių Klinikos
  • 4. Activity in the Year 2013: • 2 102 beds; • 83 532 in-patients; • 780 494 out-patient consultations; • 37 472 operations. Hospital Employees in 2013: • Total: 5078 staff members; • (302 – PhD doctors) Vilnius University Hospital Santariškių Klinikos
  • 5. University Hospital – the Basis of Studies and Research • University-based studies and scientific research; • 500 students, 260 residents, 300 doctors in refresher courses daily; • 94 new PhD within 2002-2014. • Tertiary level specialized medical services; • Science-based medicine.
  • 6. Multi-profile Adult Hospital: 28 medical centres • All therapeutic specialties, including Oncology and Neurosurgery 10 surgical centres: • Centre of Abdominal Surgery • Centre of Cardiac surgery • Centre of Ear, Nose and Throat Diseases • Centre of Eye Diseases • Centre of Urology • Centre of Thoracic Surgery • Centre of Plastic and Reconstructive Surgery • Centre of Obstetrics and Gynaecology • Centre of Anestesiology, Intensive Care and Pain Management • Centre of Neurosurgery
  • 7. Fields we are proud of • Transplantology • Cardiology and Cardiosurgery • Human Genetics • Otosurgery • Individualised medicine: oncology, haematology
  • 8. Human Organ Transplantation 2009-2013 (Even 85 % of all organ and tissue transplantations in our country are carried out at Santariškių Klinikos.) 6 62 27 127 5 3 8 37 18 123 8 14 50 27 117 9 35 53 28 167 7 0 9 48 26 155 7 1 0 20 40 60 80 100 120 140 160 180 Heart Kidney Cornea Bone marrow Liver Pancreas 2009 2010 2011 2012 2013
  • 9. Liver transplantation (2005) Pancreas-kidney complex transplantations (2008) • first time in the Baltic States.
  • 10. First implants of superficial hearts in the Baltic States (1999)
  • 11. 11 Heart Surgery Centre Changes in the number of operations
  • 12. 2010 2011 2012 VUHSK rating of congenital heart defects surgery (database of European Association For Cardio- Thoracic Surgery )
  • 13. 13 Transposition correction of large blood vessels. 0 % mortality since 2010
  • 14. Off Pump Transapical Implantation Of Artificial Chordae To Correct Mitral Regurgitation. Single Center Expierience. Early Results. The bigest experience in the world. Heart Surgery Centre
  • 16. PVI using CARTO 3 PVI using Navx Ensite
  • 17. BioVentrix Procedural Animation - Revivent TC TransCatheter Ventricular Enhancement System Video
  • 18. Hybrid operating-room and hybrid implantation of aorta valve • first time in Eastern Europe (2009)
  • 19. In 2013, for the first time in the world, a minimally invasive cardiac surgery (after myocardial infarction, with heart failure and left ventricular aneurysm) without stopping the heart and without cardiopulmonary bypass system was performed at VUH SK.
  • 20. • Biggest children/adult otosurgical center in Baltic States • 400-500 hearing reconstructive operations yearly • 160 cochlear implantation operations
  • 21. • Molecular and individualised medicine – oncology, haematology, pathology, genetics.
  • 22. 22 Autologous (self) J.R. Passweg, H. Baldomero et al., Bone Marrow Transplantation (2014), 1-7, tikslintas Bone Marrow Transplant Rates per 10 million Inhabitants in Europe in 2012 LTU – 410 Tx / 10 mio. inhabitants Allogeneic (donor) LTU – 230 Tx / 10 mio. inhabitants
  • 23. International cooperation in the field of Oncohematology 23 Years Organization Website Logo 2003 European Group for Blood and Marrow Transplantation www.ebmt.org 2010 European Leukemia Net www.leukemia-net.org 2010 Nordic Society of Pediatric Haematology and Oncology www.nopho.org 2012 European Organisation for Research and Treatment of Cancer: • Leukemia group • Soft Tissue and Bone Sarcoma group www.eortc.org 2013 The Haemato-Oncology Foundation for Adults in the Netherlands www.hovon.nl
  • 24. Zarasai Kupiškis Anykščiai Ignalina Utena Ukmergė Molėtai Panevėžys PasvalysPakruojis JoniškisN. AkmenėMažeikiaiSkuodas Kretinga PlungėTelšiai Šiauliai Radviliškis Kėdainiai JonavaŠirvintos Švenčionys VILNIUS Šalčininkai Trakai Kaišia- dorys Kaunas Prienai Alytus VarėnaLazdijai Marijam- polė Vilkaviškis Šakiai Jurbarkas Raseiniai Kelmė Šilalė Tauragė Klaipėda Palanga Šilutė Rokiškis Biržai Neringa MGC Centre for Medical Genetics Services 19871986 1989 1992 1993 1995 1996 Newborn screening for congenital hypothyreosis Psychological family counselling Molecular genetic testing Non invasive prenatal ultrasound based testing) Prenatal genetic invasive procedures 197519731971 2000 2005 2014 Newborn screening for phenylketonuria Genetic counselling Biochemical genetic testing Cytogenetic testing Molecular cytogenetic testing
  • 25. Centre for Medical Genetics Structure PRENATAL GENETIC COUNSELLING Non-invasive fetal testing, i.e. ultrasound examination, maternal blood biochemical analysis (I and II trimester of pregnancy) Invasive procedures: amniocentesis, chorionic villi sampling for cytogenetic, molecular genetic and/or biochemical genetic testing GENETIC COUNSELLING LABORATORY FOR MOLECULAR GENETICS LABORATORY FOR CYTOGENETICS LABORATORY FOR NEWBORN SCREENING AND INBORN ERRORS OF METABOLISM Postnatal Genetic Diagnostics Genetic Counselling for Teratogens usage Familial Genetic Counselling; medical psychological counselling
  • 26. Vilnius Newborn screening • Newborn screening is one of the nation's most successful public health programs – diagnostics of the treatable rare disorders before irreversible clinical signs. • In Lithuania newborns are screened for 2 disorders: • Phenylketonuria (since 1975) & Congenital hypothyreosis (since 1993) • ~30 000 newborns are screened / 1 year • 7-10 cases of both disorders are diagnosed / 1 year • Plans for 2015 – newborn screening for congenital adrenal hyperplasia and galactosemia. Newborn Screening & Diagnostics of Inborn Errors of Metabolism CENTRE FOR MEDICAL GENETICS, Vilnius University Hospital Santariskiu Klinikos -the single and unique centre for diagnostics of rare inborn errors of metabolism in Lithuania Selective screening of inborn errors of metabolism • Laboratory investigations according to clinical symptoms • ~ 2000 specific laboratory investigations pointed to diagnostics of rare metabolic disorders are performed / 1 year • 10 – 15 cases of rare disorders are diagnosed / 1 year Laboratory for newborn screening and diagnostics of inborn errors of metabolism
  • 27. Children’s hospital Affiliate of Vilnius University Hospital Santariskiu Clinic’s Provides the highest level of secondary and tertiary level health care for newborns and childrens up to 18 years old. 634 beds: • 388 beds in Santariskes (9 NICU, 12 PICU beds, 20 day surgery), day surgery, day care and palliative care beds are included • 246 beds in other location: • 50 TB beds • 196 beds for child development, rehabilitation and sanatorium treatment • 26 000 hospital admissions • 200 000 outpatient visits • 34 000 Emergency department visits • Staff (n=1616) 290 doctors 680 nurses 646 other staff
  • 28. Neonatology centre is leader in newborn and infant care in Lithuania. 300 newborns treated each year in the NICU, 95% of preterm babies survive. The youngest baby was saved weighed only 493 grams. The Newborn Emergency Team brings the most serious cases from the whole territory of Lithuania to this Centre.
  • 29. The biggest Oncohaematology centre for children in the Baltic States 151 bone marrow transplantations were done since 2002 y. We has been able to match outcomes and results to other famous European centres.
  • 30. • The largest pathology service in Lithuania, more than 30 years experience in pathologic diagnostics. • The team consist of around 100 employes. Expert pathologists, trained technicians and other medical stuff perform about 40 000 biopsies, 60 000 cytopatology cases per year. • Broad spectrum of pathology tests, including more specialized services (nephropathology, hematopathology, dermatopathology, muscle pathology). • 10 years experience of College of American Pathologists Accreditation (2000-2010 years). • The largest customers are Vilnius University Hospital Santariskiu Klinikos, Vilnius University Oncology Institute as well as up to 200 small and large health care units in Lithuania. National Centre of Pathology, Affiliate of Vilnius University Hospital Santariskiu Klinikos
  • 31. National Centre of Pathology, Affiliate of Vilnius University Hospital Santariskiu Klinikos • The diagnostic services, along with expertise in pathology informatics, form solid basis for development of digital pathology platform, enabling new approaches in quantitative tissue-based testing. • The Center embodies the Digital and Molecular Pathology Laboratory of the Santara Valley with rapidly growing involvement in research projects and services.
  • 32. Clinical Trials at VUH SK  Started in VUHSK – since 1992  Clinical trials are conducted in all the centres of VUH SK  All clinical trials are coordinated by Department of Clinical Pharmacology  About 100 preliminary contracts or intention letters on clinical trials are signed at VUH SK yearly;  Over 50 new clinical trial contracts are signed yearly (comp. with 96 new protocols in Lithuania in 2011);  Simultaneously, at least 90-100 clinical trials on medicinal products are carried on in various centres of the hospital.
  • 33. Centre of Informatics and Development • We self developed and integrated Hospital information system • We give access for our patients through Internet patient record; • We fully integrated our information system with Laboratory information systems LIS, Picture Archiving and Communication System PACS, Pathology information system, etc; • We have developed nationwide Online booking system Santariskiu klinikos is a regional leader in e-health and medical informatics
  • 34. International eHealth projects • ICTforHealth • PrimCareIT • CARRE • Baltic eHealth • eHealth for Regions • R-Bay Centre of Informatics and Development
  • 35. CARRE personalized patient empowerment & shared decision support for cardiorenal disease and comorbidities – understanding nature of comorbidity – informed estimation of disease progression – personalized alerting, planning, education DUTH OU BED VULSK KTU PIAP www.carre-project.eu This project was supported by the European Commission FP7-ICT-2013-611140 STREP duration: Nov 2013 – Oct 2016 EC contribution: 2.573,755€
  • 36. Prestigious national representation • VIVAPORT portal received the award during ISfTeH Conference (Takamatsu, Japan 2013) for the “International cooperation” • National Clinical Decision Support System (NKSPS) has been recognized as the best in “The future of telemedicine technology” nomination Centre of Informatics and Development
  • 37. ... And more of International project activities • North Investment Bank investment projects • EU Structural Funds • EEA-NOR financial mechanism projects • FP6, FP7 projects • INTERREG IIIB, IV C • Leonardo da Vinci program • COST B17 program • Telemedicine networking project Other international clinical and scientific programs Project portfolio since 2006: over 100 MEUR
  • 38. Positron emission tomography (PET) (opened in 22 of January, 2015) Radiology Diagnostic Center of Vilnius University Hospital has opened new and modern molecular diagnostics complex of Positron emission tomography / computed tomography (PET / CT). Brand new 500 square meter building has installed the latest generation and the most modern PET / CT machine in the Baltic States. Researches of molecular diagnostics complex will be conducted in accordance with the most advanced technologies in nuclear medicine.
  • 39. Molecular diagnostics complex of Positron emission tomography /computed tomography (PET / CT) (Opened in 22 of January, 2015)
  • 40. Positron emission tomography (PET) • Positron emission tomography (PET) is a nuclear medicine, functional imaging technique that produces a three- dimensional image of functional processes in the body. PET is a specialized radiology procedure used to examine various body tissues to identify certain conditions. PET may also be used to follow the progress of the treatment of certain conditions. PET is most commonly used in the fields of neurology, oncology, and cardiology, applications in other fields are currently being studied. • PET / CT research allows to assess the therapeutic response at the cellular level, thus optimizing patient-administered treatments. • PET / CT research often allow to refuse other expensive methods with limited diagnostic value.
  • 41. Centre of Obstetrics and gynecology Departments and subdepartments : 1. Obstetrics department. 2. Pregnancy pathology department. 3. Neonatal department. 4. Gynecology department. 5. Perinatology coordination center. 6. Gynecology outpatient unit. 7. IV th Operating bloc
  • 42. Centre of Obstetrics and gynecology Department of Gynecology: Provides highest level consultations for women with different gynecological problems. Specializes in endoscopic surgery, urogynecology, onkogynecology areas. Departament is increasingly seeking to apply minimally invasive treatment methods for our patients in order to make them recover and be able to go home as soon as possible . There was made one of the first and most effective female urinary incontinence (TVT, TOT), pelvic organ prolapse correction surgery. Departament is also practising peritoneal hyperthermic chemotherapy (HiPeCo) in order to treat recurrent ovarian cancer (from 2011). Department of Births: • modern and advanced maternal care, diagnosis and treatment methods, • the latest condition of the fetus analysis methods, • the performance of all surgical interventions and obstetric surgery.
  • 43. Centre of Obstetrics and gynecology 1) The Department of Obstetrics implements the most advanced technologies and modern medical equipment. Department boasts a highly-qualified medical staff and a dedicated team of nurses and support staff. It has emergency room, 6 delivery rooms and maternity unit with 35 beds. Delivery rooms provide an intimate atmosphere. Staff makes every effort to ensure the active role of mothers in decisions regarding treatment. They are committed to ensure the safety of mother and baby during labour and delivery. If there is no contraindication, mother stays with a baby from the first moment after childbirth. All women receive guidance about baby care and breastfeeding and get a support during their recovery from birth. We have 5 wards with improved accommodation facilities for additional charges. We provide lectures on different topics for pregnant women and women after childbirth. 2) Pregnancy pathology department treats high-risk pregnancy women who are experiencing complications during the pregnancy that endanger their health or the health of the foetus. The department has 22 beds, of which 8 belongs for Day Care Unit. 3) The Department of Neonatology provides care and treatment for newborn infants born in our clinic. It has 4 beds for neonatal intensive care and 6 beds for neonatal pathology. 4) Gynecology department treats a broad range of medical conditions among women at different stages in their lives - from puberty to post-One of the department's specialties is oncogynecology. The department provides modern surgical genecology, has 30 beds, of which 16 belongs to Day Care Surgery Unit. 5) Perinatology Coordination Centre provides care for pregnant women by doctors who are experienced in ultrasound scanning. Ultrasound scans are performed to the highest standards and are backed up with informative
  • 44. Department of Neurosurgery Patients in Neurosurgery department get high (3-chronic) level of service with the newest, most modern operating theater and wards. • Modern neuronavigation system enables doctors to see which part of the patients brain they touch. • Department has a machine which allows to measure not only the rate of cerebral blood flow, but also a volume. • For minimally invasive surgery we use endoscopic equipment . • Operating rooms are equipped with special, laminar ceiling, when the flow of air blown from the patient, which means that any air-borne infection is difficult to get into the patient's body. • Wards of department are equipped with a comfortable double filter door (it is important to have an infection), we also have special wards for the disabled people. • Patients have the opportunity to listen to the music, audio books, watch movies, chat with their loved ones, to learn more about their illness and treatment process, because the beds are equipped with tablet computers.
  • 45. (Opened in 1st of July, 2014) Department of Neurosurgery
  • 48. Development New building for Obstetrics and Surgery 25.000 sq.m. - opened in 2013
  • 50. Vilnius University Hospital Santariškių klinikos Thank you for your attention. Visit us at: www.santa.lt